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Pain below ribs. Taken codeine, panadol, tramadol. Blood and urine test normal. Muscle related problem?

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Posted on Tue, 20 Aug 2013
Question: Hi, I am a 53 year old lady who has had, for 2 years, a small amount of pain in my left side, especially when turning in bed. It is situated below ribs and above pelvic bone. Now very recently it has turned into a pain all day every day and at night I am unable to turn onto my left side in bed as I get this excrutiating pain, burning stabbing sharp. My GP has had me on muscle relaxants, massages, which did not help. He reckons it's around the T12 region and thinks it is muscle related. I have tried anti inflamatories, codeine and panadol, and now on tramadol which is helping most of the time, although I am still cuddling a hotwater bottle as this relieves the pain and helps me move around again. When I get this sudden stabbing burning sharp pain during the day, I am unable to move and have moments of sweating and feeling faint, but never nauseous. The hot water bottle helps me to move again. My GP has sent me for urine and blood tests and an xray but we haven't had results of xray yet, though bloods and urine all seem ok. He is going to refer me to a muscular skeletal specialist. Driving the car is very hard because I get the pain in my side when I lift my foot off the accelerator to brake and turning my head over my left shoulder all pulls in my side - pain. Do you think it is muscle? It seems strange for the pain to have come on so quickly like it did every day and night. I am interested in your comments. XXXX
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Answered by Dr. Vivek Chail (3 hours later)
Hi XXXXXXX
Thanks for writing in.

As you have said there is this pain along your left side of back, centered around level of T 12 vertebra. This pain has been around for 2 years and increases with turning in bed. You have been on anti inflammatory drugs, codeine and panadol, and now on tramadol which bring you temporary relief.

Turning in bed causing increase in pain makes me think of compression fracture involving any vertebral bone, T 12 or any other adjacent levels. This could occur due to a fall or due to weakness in bones (osteoporosis). At age 53 osteoporosis can occur on women.

If your X XXXXXXX spine is completely normal, I would start thinking in terms of other reasons (other than muscle pain) in assessing you clinically. There are many organs in the abdomen which could cause such a pain. It would be essential to put you through an ultrasound scan of abdomen following your normal X rays of dorso lumbar spine. Conditions like renal stones or ureteric stones need to be specifically excluded.

Hope your query is answered. I wish to get an update from you regarding your X XXXXXXX findings, to give you a better insight and answer further queries that you might have.

Wishing you good health.

Regards
Dr XXXX
Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Vivek Chail

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Practicing since :2002

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Pain below ribs. Taken codeine, panadol, tramadol. Blood and urine test normal. Muscle related problem?

Hi XXXXXXX
Thanks for writing in.

As you have said there is this pain along your left side of back, centered around level of T 12 vertebra. This pain has been around for 2 years and increases with turning in bed. You have been on anti inflammatory drugs, codeine and panadol, and now on tramadol which bring you temporary relief.

Turning in bed causing increase in pain makes me think of compression fracture involving any vertebral bone, T 12 or any other adjacent levels. This could occur due to a fall or due to weakness in bones (osteoporosis). At age 53 osteoporosis can occur on women.

If your X XXXXXXX spine is completely normal, I would start thinking in terms of other reasons (other than muscle pain) in assessing you clinically. There are many organs in the abdomen which could cause such a pain. It would be essential to put you through an ultrasound scan of abdomen following your normal X rays of dorso lumbar spine. Conditions like renal stones or ureteric stones need to be specifically excluded.

Hope your query is answered. I wish to get an update from you regarding your X XXXXXXX findings, to give you a better insight and answer further queries that you might have.

Wishing you good health.

Regards
Dr XXXX